RESUMO
BACKGROUND/AIMS: This study aims to evaluate the pelvic floor (PF) tension response during simulated increased intra-abdominal pressure (IAP) and the vaginal biomechanical properties. METHODS: A 3-dimensional computational finite element model for PF was developed based on magnetic resonance imaging from a nulliparous healthy volunteer. The model was used to simulate an IAP of 90 cm H(2)O and to evaluate the PF stresses in the longitudinal and transversal axes. The vaginal samples were obtained from 15 non-prolapsed female cadavers. A uniaxial tensile test to obtain stiffness and maximum stress of vaginal tissue in the longitudinal and transversal axes was performed. RESULTS: The simulated IAP was associated with a similar PF stress state in the longitudinal and transversal axes. The stiffness and maximum stress in vaginal tissues presented a great variability between subjects. There was no difference in the vaginal tissue elasticity (6.2 ± 1.5 vs. 5.4 ± 1.1 MPa; p = 0.592) and maximum stress (2.3 ± 0.5 vs. 2.6 ± 0.9 MPa; p = 0.692) regarding the measurements in the longitudinal and transversal axes. CONCLUSION: The isotropic biomechanical behavior of vagina is in agreement with the PF stress state response during increased IAP.
Assuntos
Abdome/fisiologia , Pressão , Vagina/fisiologia , Adolescente , Adulto , Fenômenos Biomecânicos/fisiologia , Simulação por Computador , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Modelos Biológicos , Diafragma da Pelve/fisiologia , Estresse Mecânico , Resistência à Tração , Adulto JovemRESUMO
INTRODUCTION: Pelvic floor (PF) dysfunctions represent a frequent and complex problem for women. The interaction between the vagina and its supportive structures, that are designed to support increases in abdominal pressure, can be considered a biomechanical system. Recent advances in imaging technology have improved the assessment of PF structures. The aim of this paper is to review the applications of biomechanics in urogynecology. METHODS: The available literature on biomechanics research in urogynecology was reviewed. RESULTS: Computational models have been demonstrated to be an effective tool to investigate the effects of vaginal delivery and PF dysfunctions. Biomechanical analysis of PF tissues provides a better understanding on PF dysfunctions etiology. These studies are also important for the development of synthetic prostheses utilized in PF surgery. CONCLUSION: An interdisciplinary and multidisciplinary collaborative research, involving bioengineers and clinicians, is crucial to improve clinical outcomes in patients with PF dysfunctions.
Assuntos
Bioengenharia , Diafragma da Pelve/fisiopatologia , Diafragma da Pelve/cirurgia , Pesquisa Translacional Biomédica , Animais , Fenômenos Biomecânicos , Simulação por Computador , Parto Obstétrico/efeitos adversos , Feminino , Ginecologia , Humanos , Modelos Biológicos , Gravidez , Próteses e Implantes , Ratos , Urologia , Prolapso Uterino/etiologia , Prolapso Uterino/cirurgia , Vagina/fisiopatologiaRESUMO
Pelvic floor muscle (PFM) strength measurement provides useful information for the study of pelvic floor dysfunctions. Vaginal digital palpation, intravaginal pressure measurements, and the use of a dynamometric speculum represent currently available clinical methods for evaluating PFM strength. However, none of these methods provide a dynamic measurement of pelvic floor strength in multiple directions simultaneously. The aim of the present paper is to report the development and first measurement trial of a device that follows the vaginal canal morphology and is able to measure pelvic floor strength multidirectionally.
